Difference between revisions of "Cachexia"

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'''Quick Start:''' ''You can begin to add to or edit text on this wiki doc page by clicking on the edit button above and to the left on this same page. Type in the text you want to add. Once you are done, click the save changes button at the bottom.
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{{SignSymptom infobox |
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  Name        = Cachexia |
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  ICD10      = R64 |
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  ICD9        = {{ICD9|799.4}} |
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}}
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'''Cachexia''' ([[IPA chart for English|pronounced]] {{IPA|[kəˈkɛksiə]}}) is [[weight loss|loss of weight]], [[muscle atrophy]], fatigue, weakness and significant [[anorexia (symptom)|loss of appetite]] in someone who is not actively trying to lose weight. It can be a [[sign (medicine)|sign]] of various underlying disorders; when a patient presents with cachexia, a doctor will generally consider the possibility of [[cancer]], certain [[infectious disease]]s (e.g. [[tuberculosis]], [[AIDS]]) and some [[autoimmune disorder]]s.
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Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, [[asthenia]], and [[anemia]], and response to standard treatment is usually poor.
  
'''Cachexia'''
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==Disease settings==
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Cachexia is often seen in end-stage [[cancer]], and in that context is called "[[cancer cachexia]]".  It was also prevalent in [[AIDS]] patients before the advent of triple-therapy for that condition; now it is seen less frequently in those countries where such treatment is available.  In those patients who have [[Congestive Heart Failure]], there is also a cachectic syndrome.  Also, a cachexia co-morbidity is seen in patients that have any of the range of illnesses classified as "[[COPD]]" (Chronic obstructive pulmonary disease), particularly emphysema.
  
==== Editor-In-Chief: ====
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In each of these settings there is full-body wasting, which hits the [[skeletal muscle]] especially hard, resulting in [[muscle atrophy]].
  
Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please email [[mgibson@perfuse.org]] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
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==Mechanism==
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The exact mechanism in which these diseases cause cachexia is poorly understood, but there is probably a role for [[inflammation|inflammatory]] [[cytokine]]s such as [[tumor necrosis factor-alpha]] (TNF-α) -which is also nicknamed ''cachexin'' for this reason-, [[Interferon|Interferon gamma]] (IFNɣ), and [[Interleukin 6]] (IL-6), as well as the [[tumor]] secreted [[proteolysis]] inducing factor (PIF).
  
= Overview = 
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Related malnutrition syndromes are [[kwashiorkor]] and [[marasmus]], although these do not always have an underlying causative illness; they are most often symptomatic of severe [[malnutrition]].
  
===== References =====
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Those suffering from the eating disorder anorexia nervosa appear to have high plasma levels of [[ghrelin]]. Ghrelin levels are also high in patients who have cancer-induced '''cachexia''' (Garcia et al 2005).
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= Epidemiology and Demographics =
 
  
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== See also ==
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* [[Wasting]]
  
===== References =====
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==External links==
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*[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=books&doptcmdl=GenBookHL&term=cachexia+AND+cmed6%5Bbook%5D+AND+357815%5Buid%5D&rid=cmed6.section.40200 Manifestations of Cachexia], from [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?call=bv.View..ShowTOC&rid=cmed6.TOC&depth=2 Cancer Medicine]
= Risk Factors =
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*[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=books&doptcmdl=GenBookHL&term=cachexia+AND+cmed6%5Bbook%5D+AND+357834%5Buid%5D&rid=cmed6.section.40218 Treatment of Cachexia], from [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?call=bv.View..ShowTOC&rid=cmed6.TOC&depth=2 Cancer Medicine]
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*[http://www1.va.gov/resdev/news/press_releases/wasting-syndrome-1209802.cfm Scientists find key to 'wasting syndrome' seen in cancer, AIDS (U.S. Department of Veterans Affairs)]
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*[http://lpi.oregonstate.edu/infocenter/vitamins/vitaminE/index.html Vitamin E and Disease Treatment (Oregon State University)]
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*[http://www.biomedcode.com BioMedCode Animal Models for Cachexia / MOF (Tg211, TgE1355)]
  
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{{Symptoms and signs}}
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[[Category:Medical signs]]
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[[Category:Physiology]]
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[[Category:Pathology]]
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[[Category:Symptoms]]
  
===== References =====
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[[de:Kachexie]]
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[[es:Caquexia]]
= Screening =
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[[fr:Cachexie]]
 
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[[nl:Cachexie]]
 
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[[ja:悪液質]]
===== References =====
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[[pl:Wyniszczenie]]
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[[pt:Caquexia]]
= Pathophysiology & Etiology=
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[[qu:Amaychura]]
 
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[[sv:Kakeksi]]
===== References =====
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[[zh:惡病體質]]
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= Molecular Biology =
 
 
 
 
 
===== References =====
 
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= Genetics =
 
 
 
 
 
===== References =====
 
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= Natural History =
 
 
 
 
 
===== References =====
 
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= Diagnosis =
 
 
 
== Differential Diagnosis ==
 
 
 
 
 
===== References =====
 
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== History and Symptoms ==
 
 
 
 
 
===== References =====
 
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== Physical Examination ==
 
 
 
=== Appearance of the Patient ===
 
 
 
=== Eyes ===
 
 
 
=== Ear Nose and Throat ===
 
 
 
=== Heart ===
 
 
 
=== Lungs ===
 
 
 
=== Abdomen ===
 
 
 
=== Extremities ===
 
 
 
=== Neurologic ===
 
 
 
=== Other ===
 
 
 
===== References =====
 
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== Laboratory Findings ==
 
 
 
=== Electrolyte and Biomarker Studies ===
 
 
 
 
 
=====References=====
 
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=== Electrocardiogram ===
 
 
 
 
 
=====References=====
 
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=== Chest X Ray ===
 
 
 
 
 
=====References=====
 
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=== MRI and CT ===
 
 
 
 
 
=====References=====
 
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=== Echocardiography or Ultrasound ===
 
 
 
 
 
=====References=====
 
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=== Other Imaging Findings ===
 
 
 
=====References=====
 
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=== Other Diagnostic Studies ===
 
 
 
===== References =====
 
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= Risk Stratification and Prognosis=
 
 
 
 
 
===== References =====
 
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= Treatment =
 
 
 
 
 
== Pharmacotherapy ==
 
 
 
=== Acute Pharmacotherapies ===
 
 
 
===== References =====
 
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=== Chronic Pharmacotherapies ===
 
 
 
 
 
===== References =====
 
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== Surgery and Device Based Therapy ==
 
 
 
=== Indications for Surgery ===
 
 
 
 
 
===== References =====
 
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=== Pre-Operative Assessment ===
 
 
 
 
 
===== References =====
 
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=== Post-Operative Management ===
 
 
 
 
 
===== References =====
 
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=== Transplantation ===
 
 
 
 
 
===== References =====
 
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== Primary Prevention ==
 
 
 
 
 
===== References =====
 
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== Secondary Prevention ==
 
 
 
 
 
===== References =====
 
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== Cost-Effectiveness of Therapy ==
 
 
 
 
 
===== References =====
 
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== Future or Investigational Therapies ==
 
 
 
 
 
===== References =====
 
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==Suggested Revisions to the Current Guidelines==
 
 
 
 
 
== References ==
 
<biblio>
 
</biblio>
 
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== Acknowledgements ==
 
The content on this page was first contributed by:  
 
 
 
List of contributors:
 
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== Suggested Reading and Key General References ==
 
 
 
== Suggested Links and Web Resources ==
 
 
 
== For Patients ==
 
 
 
= Basic Instructions on Editing This Page =
 
 
 
== Please use this template for adding material regarding a disease state ==
 
 
 
It preserves a consistent look and feel to the site and makes navigation for others easier.
 
 
 
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Click on the edit button at the top left. Next, simply type in the material that you wish to add under the appropriate heading. Use a paragraph break (enter button) to separate the lines. Check your addition to the page or editing by clicking on the preview button at the bottom. Next check your spelling. Finally, click the save changes button. It's that simple!
 
 
 
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[[Category:DiseaseState]]
 

Revision as of 01:52, 1 October 2007

Name of Symptom/Sign:
Cachexia
Classifications and external resources
ICD-10 R64
ICD-9 799.4

Cachexia (pronounced [kəˈkɛksiə]) is loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite in someone who is not actively trying to lose weight. It can be a sign of various underlying disorders; when a patient presents with cachexia, a doctor will generally consider the possibility of cancer, certain infectious diseases (e.g. tuberculosis, AIDS) and some autoimmune disorders. Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, asthenia, and anemia, and response to standard treatment is usually poor.

Disease settings

Cachexia is often seen in end-stage cancer, and in that context is called "cancer cachexia". It was also prevalent in AIDS patients before the advent of triple-therapy for that condition; now it is seen less frequently in those countries where such treatment is available. In those patients who have Congestive Heart Failure, there is also a cachectic syndrome. Also, a cachexia co-morbidity is seen in patients that have any of the range of illnesses classified as "COPD" (Chronic obstructive pulmonary disease), particularly emphysema.

In each of these settings there is full-body wasting, which hits the skeletal muscle especially hard, resulting in muscle atrophy.

Mechanism

The exact mechanism in which these diseases cause cachexia is poorly understood, but there is probably a role for inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) -which is also nicknamed cachexin for this reason-, Interferon gamma (IFNɣ), and Interleukin 6 (IL-6), as well as the tumor secreted proteolysis inducing factor (PIF).

Related malnutrition syndromes are kwashiorkor and marasmus, although these do not always have an underlying causative illness; they are most often symptomatic of severe malnutrition.

Those suffering from the eating disorder anorexia nervosa appear to have high plasma levels of ghrelin. Ghrelin levels are also high in patients who have cancer-induced cachexia (Garcia et al 2005).

See also

External links

de:Kachexie nl:Cachexie qu:Amaychura sv:Kakeksi


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